Nuclear Medicine Department, Hospital General Universitario, C/Obispo Rafael Torija S/N, 13005, Ciudad Real, Spain.
Mathematics Department, Universidad de Castilla-La Mancha, Ciudad Real, Spain.
Sci Rep. 2021 Apr 1;11(1):7389. doi: 10.1038/s41598-021-86759-1.
To assess the predictive and prognostic aim of interim and end-treatment F-fluorocholine PET/CT (FCH-PET/CT) and Tc-methilen diphosphonate bone scintigraphy (BS) in patients with castration-resistant prostate cancer and bone metastases (CRPC-BM) treated with Radium 223 dichloride (Ra). Prospective and multicentre ChoPET-Rad study including 82 patients with CRPC-BM. Baseline, after 3 (interim) and 6 doses (end-treatment) BS and FCH PET/CT were performed in patients who meet the study criteria. Clinical variables, imaging and clinical progression were obtained and their association with progression free survival (PFS), and overall survival (OS) was studied. Agreement between BS and FCH PET/CT response was assessed using Kappa (K) analysis. Median of PFS and OS was 3 and 16 months, respectively. Agreement between interim BS and FCH PET/CT was weak (K: 0.28; p = 0.004). No agreement was observed between end-treatment diagnostic studies. Interim and end-treatment FCH PET/CT were related to PFS (p = 0.011 and p < 0.001, respectively). Therapeutic failure and interim BS and FCH PET/CT showed association with OS (p < 0.001, p = 0.037 and p = 0.008, respectively). Interim and end-treatment FCH PET/CT were good predictors of biochemical progression in patients treated with Ra. Therapeutic failure and progression in interim BS or FCH PET/CT were adverse factors for OS.
评估镭 223 二氯化物（Ra）治疗去势抵抗性前列腺癌伴骨转移（CRPC-BM）患者的中期和治疗结束时 F-氟代胆碱 PET/CT（FCH-PET/CT）和 Tc-亚甲基二膦酸盐骨闪烁扫描（BS）的预测和预后目的。前瞻性多中心 ChoPET-Rad 研究纳入 82 例 CRPC-BM 患者。符合研究标准的患者在基线、第 3 次（中期）和第 6 次剂量（治疗结束）时进行 BS 和 FCH PET/CT。获得临床变量、影像学和临床进展，并研究其与无进展生存期（PFS）和总生存期（OS）的关系。使用 Kappa（K）分析评估 BS 和 FCH PET/CT 反应之间的一致性。中位 PFS 和 OS 分别为 3 个月和 16 个月。中期 BS 和 FCH PET/CT 之间的一致性较弱（K：0.28；p=0.004）。未观察到治疗结束时诊断研究之间的一致性。中期和治疗结束时的 FCH PET/CT 与 PFS 相关（p=0.011 和 p<0.001）。治疗失败以及中期 BS 和 FCH PET/CT 与 OS 相关（p<0.001、p=0.037 和 p=0.008）。中期和治疗结束时的 FCH PET/CT 是 Ra 治疗患者生化进展的良好预测指标。中期 BS 或 FCH PET/CT 中的治疗失败和进展是 OS 的不利因素。
